VICCA: Visual Interpretation and Comprehension of Chest X-ray Anomalies in Generated Report Without Human Feedback

Abstract

As artificial intelligence (AI) becomes increasingly central to healthcare, the demand for explainable and trustworthy models is paramount. Current report generation systems for chest X-rays (CXR) often lack mechanisms for validating outputs without expert oversight, raising concerns about reliability and interpretability. To address these challenges, we propose a novel multimodal framework designed to enhance the semantic alignment and localization accuracy of AI-generated medical reports. Our framework integrates two key modules: a Phrase Grounding Model, which identifies and localizes pathologies in CXR images based on textual prompts, and a Text-to-Image Diffusion Module, which generates synthetic CXR images from prompts while preserving anatomical fidelity. By comparing features between the original and generated images, we introduce a dual-scoring system: one score quantifies localization accuracy, while the other evaluates semantic consistency. This approach significantly outperforms existing methods, achieving state-of-the-art results in pathology localization and text-to-image alignment. The integration of phrase grounding with diffusion models, coupled with the dual-scoring evaluation system, provides a robust mechanism for validating report quality, paving the way for more trustworthy and transparent AI in medical imaging.